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A union representing staff at the RVH’s beleaguered Accident and Emergency Department has rubbished the Health Minister’s claim that last week’s crisis at the hospital was a one-off.

The union also claimed that a major incident plan was put into action only because the media had been alerted to the huge backlog at A&E and were asking questions of the Belfast Trust.

The major incident was declared at the RVH last Wednesday. Additional staff had to be called in and extra beds made available to relieve pressure on the A&E. Patients and staff alike say they witnessed clinical staff in tears, such was the strain they were under.

However, the public service union Unison says the crisis was not unique but that it’s “always bad or, like this time, disastrous. It is never good.”

Health Minister Edwin Poots was booed by protesting staff during a visit to the site last Thursday. They say the problem is a “continuous crisis” that has been going on for two years and they have appealed to politicians for help.

“This particular incident didn’t crop up on Wednesday, it had been going on last since Monday,” said Catherine Harte, Joint Branch Secretary of Unison at the Royal. “There were more people through the Emergency Department on Monday than on Wednesday. The nursing staff never call the trade union but they did on Monday because the situation was horrendous and they needed help.

“Doctors and medical staff have been asking for help for quite some time, in their opinion an emergency should have been called long before it was.”

Catherine went on to explain the scenes, which she described as being “like Beirut”.

“On Tuesday night, senior managers were down in the Emergency Department trying to help but they are not clinicians,” she said.

“On Wednesday, there were people lying all over casualty and the place was pure bedlam. There were trolleys everywhere, plus we had people coming from Lisburn and Craigavon to the Emergency Department.

“At one point, the noise was so bad that you couldn’t hear the emergency phone and the discharge ward was being used for admissions.

“Casualty was like Beirut, there was nothing during the Troubles compared to what happened here. It was wall-to-wall trolleys, no seats for relatives, every possible space was taken up.”

Conor McCarthy, Co-Chair of Unison at the Royal, said the Trust is now driven by targets rather than clinical need.

“The situation is always bad or, like this time, disastrous. It is never good,” he said. “With staff having contacted the media, the Trust had no option but to call a major incident.

“The place was tidied up for the Minister coming on Thursday. How can they find extra staff to put on a good show when the Minister comes but they can’t find them for ill patients at any other time?

“The problem here is that patients are being farmed out to meet targets. What is more important, patients being admitted on clinical need or because they are about to breach the 12-hour target?

“Senior managers are fixated on targets and the relationship between them and the clinical staff is bad.”

Unison is adamant that the staff and facilities at the hospital are second to none, but they say the cuts are taking their toll and putting lives at risk. Equally, the assurances that the Emergency Department would not suffer with the closure of services in Mid-Ulster and Whiteabbey and the closure of A&E in the City Hospital have been proved to be incorrect, says the union. Added to that, the decision taken over Christmas to limit A&E services in Lisburn and Downpatrick has further “compounded the crisis”.

“It is now clear that the drive to implement Transforming Your Care by cutting, closing and privatising A&E departments while at the same time reducing bed numbers across our Health Service is putting patients at risk,” said Conor, who has appealed to politicians to help.

“This is a fantastic hospital and the staff can deliver, but someone has to step up and speak out because they are getting away with these cuts and closures and this is the result.

“An election is coming up, people need to shout loud to get the Health Service the attention it deserves politically so we can get it fixed.

“If the political will existed to combat this issue that there is for flags and parades, we would all be in a better place, but there is no political will to fix this.

“There are overnight lengthy negotiations about a flag. A flag wouldn’t save someone lying here in the Emergency Department.

“Who is going to stick their neck out and veto all these cuts? Someone has to hold the Department of Health to account. Who is going to show teeth on an issue that matters to every one of us? Some parties can say they don’t agree, but who is going to step up and take action?

“The public need to be up in arms with their representatives to get this fixed.”

A spokeswoman for the Belfast Trust said they are working to implement an action plan in the Emergency Department following an inspection conducted last year.

“Belfast Trust’s Emergency Department (ED) at the RVH experienced extreme pressures last week and as a result we declared it a major incident,” she said. “This is a mechanism to call in extra staff at short notice to deal with particularly difficult situations. Our staff dealt professionally and quickly with a difficult situation and within a few hours it had been rectified.

“We would like to pay tribute to the staff who work in such a challenging and demanding environment. They work under significant pressure and at all times put the needs of our patients first.

“The department continues to be busy, which is what is to be expected at this time of year, and staff continue to work extremely hard to see patients as quickly as they can. All patients are seen and triaged when they arrive in ED, and anyone requiring emergency treatment is always seen immediately.

“Our clinical and managerial staff work in a tight partnership to focus on alleviating the pressure in ED and they are committed to ensuring that Belfast Trust delivers the best possible care for our patients.

“The College of Emergency Medicine was invited to visit the Trust in 2013 and, based on this visit, provided the Trust with a report and recommendations for consideration. Emergency Department consultants and management team have developed an action plan based on the recommendations, and are working both in Trust and with Health & Social Care Board colleagues to realise this plan.

“The Trust plans to invite the College of Emergency Medicine for a follow-up visit.”